Expat Focus International Healthcare Update 26 April 2017

Expats on overseas assignments are increasingly at risk from terrorism and populism upsurges, according to a survey.

The risk map published by insurance firm Aon reveals that there was a 14% increase in worldwide terrorist attacks last year.

In addition, a growing nationalism movement is also adding to a volatile environment in which international businesses operate – and both issues are set to increase this year.

A spokesman for the firm said: “These shifting dynamics around political violence and terrorism present an increasing challenge for employers.

“Those firms with an international and domestic footprint have the potential to experience an event that could impact their expat employees, assets and operations.”

The firm is now urging businesses with expat employees to develop strategies that will tackle a business threat should it occur.

Their report also reveals that gas and oil companies accounted for 41% of all terrorist attacks in 2016 on commercial interests and this has continued into 2017.

Countries topping the list of targets in the energy sector are Nigeria and Colombia.

Co-payments hit expats

Expats in the UAE are being cautious about how often they use their medical insurance card since co-payment requirements – that’s the amount the expat will pay in out-of-pocket expenses before being refunded - means they're spending more than they used to for a pharmacy or hospital visit.

While insurance firms were willing to underwrite health insurance cover for an employee in their annual contract, the co-payments used to be small.

However, the amount that needs be paid of the expat’s medical bill ranges from 20% to 30% as the norm and for many expats this is an extra expense they can do without.

One media outlet says the growth in co-payments is also expensive for expats who take out health insurance for their family members as part of their visa renewal or application.

The warning about the growth in co-payments comes from various health insurance brokers responding to news reports about the take-up of medical insurance for expats since the cut-off date for mandatory cover was March 31. Non-compliance will see the expat being hit with a stiff fine.

Meanwhile, it has been revealed that 4.56 million health insurance policies have now been issued to people in Dubai - compared with 1.1 million in 2015.

Dubai's Health Authority has said the next step is to bring in a new billing system next year to make paying medical bills easier.

Health insurance hurdle faces EU citizens

Growing numbers of EU citizens are looking to apply for UK residency but they are seeing their applications fail because of a health insurance hurdle.

According to European Union rules, students and those who are deemed to be financially self-sufficient should have health insurance cover while living in the UK.

When applying for permanent residency, applicants must prove they have lived in the UK for five continuous years but if they do not have comprehensive sickness insurance (CSI) then they will not qualify for residency.

According to one news report, many EU citizens applying for UK citizenship have never heard of CSI.

The idea behind CSI is for EU migrants to take out extra health insurance so they do not become an expensive burden in their new country for their health care needs.

The importance of pre-travel health programmes

Fewer than one in four employers have in place a pre-travel health programme which means large numbers of expats heading overseas are at risk of catching infectious diseases.

The warning comes from International SOS, a travel and medical risk security service firm, which says the issue needs to be better managed.

The firm points to its own research which reveals that the growing number of offshore medical injury and accident cases, including those on gas and oil rigs, have risen from 13% of all incidents in 2014 to 41% of cases last year.

A spokesman for International SOS said: “The fight against malaria is helping to reduce the world's burden but we still receive thousands of calls every year to our assistance centre for this disease.

“Malaria can have serious health consequences and for employers it can result in a failed assignment and significant costs.

“Businesses can help mitigate health risks with simple measures including educating their employees before they travel and monitor outbreaks and provide preventative measures.”

Expats among those confused about private health insurance

A survey in Australia has revealed that many people, including expats living there, are confused about private health insurance.

Many of them could save hundreds of dollars by simply switching health insurance providers but most opt not to do so.

The survey by Big Health Insurance Switch points to a range of misunderstandings that have stopped a growing number of households from renewing their health insurance cover this year.

Premiums in Australia have been rising in recent years with growing numbers of people deciding they can no longer afford health cover.

That's underlined with news that the average increase for premiums in April was 4.8% or $200 but the increase over the last 10 years now amounts to 71%.

Indeed, the survey has found that two in five Australians didn't know what their premium increase for April is, and 45% said that comparing health insurance policies was ‘too difficult’.

Another one in six believe strongly that they will be penalised if they switch insurance providers.

By failing to switch providers, Australians and expats are losing out on the potential of saving of hundreds of dollars, says the organisers of the research.

Meanwhile, the plan by Australia to phase out the 457 visa immigration scheme, which enables expats to live and work in the country temporarily, has an impact on the private health insurance industry there.

That's the view from some private health insurance providers who have seen growing numbers of Australians and expats declining to renew health insurance policies because of rising premiums.

Now industry experts say that with fewer expats heading ‘down under’ means there will be even fewer of them taking up health insurance policies.

Some health funds have seen their share prices fall but they remain optimistic that the replacement visa schemes for expats will still deliver new customers.

Growing gap between healthcare benefits and needs

There is a growing gap between an employee's health care needs and the benefits now being offered by their employers around the world, says health insurance provider Cigna.

In its third well-being survey, they say that just one in three of respondents said they would seek professional help when they fall ill and would instead opt to rely on their own diagnosis and treatment.

Also, fewer than one in five employees have their dental benefits covered by their employer.

The survey also revealed that respondents say they are lacking the time and money to take care of their families with the biggest fall in family welfare needs for employees is for taking care of their children's health, financial and educational needs.

Cigna's study also points to workplace wellness programmes not yet being an important reason for choosing an employer but they are cited as a common reason for staying with one.

Also, employees are looking to use, or are planning to use, a health app increasingly over the coming year and 45% said they would be willing to share their personal health data to benefit others.

Use Emirates ID card to access healthcare

The UAE's National Health Insurance Company, or Daman, has announced members can access the company's network by using their Emirates ID (EID) card.

Healthcare providers have now been trained to check the Daman, as well as the Thiqa, card to ensure the holder can receive medical services.

A new online platform has been tested by a variety of health care providers to ensure the service meets everyone's needs.

The move also means that members of the health insurance provider will need to carry just one card to access medical and healthcare services.

In other healthcare news...

Fears over access to healthcare benefits for British expat retirees has led to 41% of them opting to remain in the UK rather than follow their plans to retire to Spain, France and other EU countries. The findings from retirement home provider Anchor reveal that the number of expat retirees looking to return to the UK is also rocketing with worries over future healthcare needs being a big concern.

A survey by The Health Insurance Group has revealed that 40% of companies in the UK have, are or are going to put, in place a policy that covers health and well-being. Another 35% are looking to implement one and one in six firms said their employee's health and well-being is one of the top six HR issues they must face. The firm has also recently unveiled a platform for SME employers that delivers support, discounts and HR tools.

Virtual healthcare technology is becoming increasingly popular in the UAE with three health start-ups launching in the past year. They offer patients a video consultation with a doctor and access to counselling and information. However, the take-up of the initiatives is lower and slower than many had anticipated.

Fears that expats in the GCC region may see their health premiums increase after the introduction of VAT next year are being reassured that medical care costs are likely to be shielded from the planned 5% tax.
Global Benefits Group has announced it is forming a partnership with Georgia Insurance to offer regional and local products in Georgia and across eastern and central Europe. The new outfit, to be called Global Benefits Georgia, will offer international insurance products and help with risk management and non-life insurance issues.

Now Health International has announced that it is launching group products in Abu Dhabi which will complete its ambitious expansion plans across the UAE. The plans are available for employers with at least 10 employees and who have staff both in the Emirates and in other parts of the world.

The government in Nepal has unveiled its Health Insurance Act which could lead to basic health care coverage for all citizens and expats living in the country. Among the services being offered include out- an in-patient care, family planning, immunisation as well as yoga and emergency care.

The Irish government is being warned that thousands of people will drop their healthcare insurance cover if policies are hiked by €1,000 and tax relief is scrapped. Most families are facing paying an extra €300 and €500 under price rises that have already been announced.

In a bid to encourage its citizens and expats there to sign up to a state-sponsored health insurance programme, Vietnam has sharply increased medical fees. For those without health insurance cover, most treatments will now be very expensive and some prohibitive.

Hospitals in the expat paradise of Phuket in Thailand have revealed they are writing off huge sums after treating uninsured expats. The figures also reveal a 54% increase the number of expats dying there last year with Australia saying 109 of its citizens died in the year up to June 2015.

A newspaper in Murcia, Spain, has accused British expats there of burying their heads in the sand over Brexit and being too focused on losing their healthcare rights.

Medical and healthcare tourism is booming in Malaysia with medical tourists and expats increasingly heading there for cheap and effective treatments. Most patients are from India, China and Japan and also the UK, according to the country's Healthcare Travel Council.

A medical centre aimed at delivering culturally-sensitive care for expats in Holland will now open five days a week. The SGE International healthcare centre is open in Eindhoven.

The excellent healthcare provision for expats has led to Singapore remaining as Asia's most liveable location for expatriates, according to an ECA International survey. The medical facilities scored well along with excellent infrastructure in the city-state and low crime rates.

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